Canada's country-wide EHR rollout hits snags
Canada Health Infoway has met a number of serious challenges concerning its EHR deployment timeline and it needs to implement more standards, controls and progress indicators, according to a report this week from Canada's Auditor General, Sheila Frase.
Infoway, a federally funded, nonprofit corporation tasked with leading Canada’s EHR development, has the stated goal that 50 percent of Canadians will have their EHR available to their authorized healthcare professionals by 2010, and 100 percent by 2016.
However, by March 31, only 17 percent of Canadians were living in a province or territory where a complete EHR system was available, the report stated.
“While our discussion of future challenges is not based directly on our audit work, we have raised them to indicate the magnitude of the efforts still needed,” stated Fraser.
The Office of Auditor General (OAG) examined how Infoway manages funds from the federal government to achieve its goal of making compatible EHRs available across Canada. In addition, the OAG is looking at Health Canada's role in ensuring that Infoway complies with the agreements. The audit focused on the fiscal years 2006-2008 and was completed at the end of April.
Infoway has been granted $1.6 billion by the federal government and has allocated $1.2 billion to invest jointly with the provinces and territories in EHR projects, and $400 million for other related priorities.
It is the role of the provinces and territories to propose the projects to Infoway for funding and to implement them.
The OAG found that the following:
Concurrent with the OAG’s audit, six provincial audit offices audited how EHRs funded by Infoway or provincial governments are being implemented in their respective provinces. The provincial audit offices will issue each report separately; a joint summary report on all of the audits will be issued in 2010.
Infoway, a federally funded, nonprofit corporation tasked with leading Canada’s EHR development, has the stated goal that 50 percent of Canadians will have their EHR available to their authorized healthcare professionals by 2010, and 100 percent by 2016.
However, by March 31, only 17 percent of Canadians were living in a province or territory where a complete EHR system was available, the report stated.
“While our discussion of future challenges is not based directly on our audit work, we have raised them to indicate the magnitude of the efforts still needed,” stated Fraser.
The Office of Auditor General (OAG) examined how Infoway manages funds from the federal government to achieve its goal of making compatible EHRs available across Canada. In addition, the OAG is looking at Health Canada's role in ensuring that Infoway complies with the agreements. The audit focused on the fiscal years 2006-2008 and was completed at the end of April.
Infoway has been granted $1.6 billion by the federal government and has allocated $1.2 billion to invest jointly with the provinces and territories in EHR projects, and $400 million for other related priorities.
It is the role of the provinces and territories to propose the projects to Infoway for funding and to implement them.
The OAG found that the following:
- Infoway has developed an approach to providing compatible EHRs by identifying requirements and components of an EHR, and developing a blueprint for the design of health information systems. It established appropriate governance mechanisms and developed a risk management strategy. It has implemented appropriate management controls for operational spending, although controls for contracting goods and services need to be strengthened.
- In the 29 EHR projects examined, Infoway has ensured that provinces and territories designed the projects to comply with requirements such as its blueprint and standards. It also identified project-specific risks and monitored them. However, Infoway has not obtained the results of conformance testing on EHR systems. Therefore, it does not have sufficient assurance that standards have been implemented as required.
- Infoway has made considerable efforts to report on the progress of the EHR initiative. However, it has not reported on other indicators of progress, such as the extent to which completed systems meet requirements for compatibility. Nor does it report on the adoption or use of completed systems by healthcare professionals, although it considers low adoption rates a serious risk to the EHR initiative.
Concurrent with the OAG’s audit, six provincial audit offices audited how EHRs funded by Infoway or provincial governments are being implemented in their respective provinces. The provincial audit offices will issue each report separately; a joint summary report on all of the audits will be issued in 2010.